Perigraft seroma is uncommon complication of polytetrafluoroethylene(PTFE) grafts applied as an arteriovenous shunt for hemodialysis. It is a collection of clear, sterile fluid confined to nonsecretory fibrous pseudomembrane, most commonly localized around the middle and distal portion of graft. The possible etiologic factors of perigraft seroma include poor graft incorporation, mechanical graft damage caused by alcohol and povidone-iodine, intraoperative streching of the graft, variations in quality control at the time of manufacture and contributing factors such as anemia and coagulopathy in uremia. The best strategy for management of perigraft seroma is not clear. spiration or drainage alone is not effective, and some authors advocate graft removal. We report a case of perigraft seroma around arterial end of PTFE graft along with a brief review of the literatures.
Anemia ; Drainage ; Humans ; Polytetrafluoroethylene ; Povidone-Iodine ; Quality Control ; Renal Dialysis* ; Seroma* ; Transplants ; Uremia

No abstract available.
Carcinoma, Basal Cell* ; Nevus*

No abstract available.
Bowen's Disease*

Recently refractive corneal surgery has been increasing and intraocular lens implantation is a routine procedure during cataract surgery. Many people have various activities in the evening such as night driving, thus it may be very important measuring the pupil size in the dark in determining the size of the optical zone. We measured pupil size of sixty normal adult candidates in darkness of 0, 20, 60, 100 lux and also in the bright illumination of 200 lux for comparison using near lens camera and slide film. The pupils became larger with younger age and increased darkness. Pupil Size(log mm) = 4.57 - 0.0388 X Age(year) - 0.005 X Luminance(lux). The average pupil size of all age groups were 7.0mm, 6.56mm, 5.97mm, 5.4mm sequencially in darkness and 4.77mm in brightness(200 lux). The average pupil size of 20~30 year old group who are socially active even at night was 7.18mm and 8.4mm in maximum. This has significant meaning clinically. Additionally the size of pupil became larger with increased corneal diameter and the amount of anisocoria tended to be greater with the increase of the darkness.
Adult* ; Anisocoria ; Cataract ; Darkness ; Humans ; Lens Implantation, Intraocular ; Lighting ; Pupil*

BACKGROUND: The external jugular vein (EJV) is a useful intravenous (IV) cannulation site for anesthesiologists, although it has a relatively high failure rate. Unlike other central veins, visualization of the EJV is important during IV cannulation, and the Valsalva maneuver distends the jugular venous system. However, the relationship between the maneuver and EJV visibility remains unknown. This study compared EJV visibility before and after the Valsalva maneuver. METHODS: This was a prospective observational study that included 200 participants. After the induction of anesthesia, EJV visibility grade, depth from the skin to the EJV superficial surface (EJV depth), and EJV cross-sectional area (CSA) before the Valsalva maneuver were measured. The same parameters were measured after the Valsalva maneuver was performed. The EJV visibility grade was defined as grade A: good appearance and good palpation, grade B: poor appearance and good palpation, and grade C: poor appearance and poor palpation. RESULTS: Patient body mass index and EJV depth affected the EJV visibility grade before the Valsalva maneuver (p < 0.05), although EJV CSA did not. The Valsalva maneuver distended EJV CSA and reduced EJV depth, although these changes were not correlated with EJV visibility grade. With regard to EJV visibility, 34.0% of grade B cases and 20.0% of grade C cases were improved by the Valsalva maneuver. CONCLUSIONS: Although the Valsalva maneuver improved EJV CSA and EJV depth, it did not greatly affect EJV visibility grade.
Anesthesia ; Body Mass Index ; Catheterization ; Humans ; Jugular Veins* ; Observational Study ; Palpation ; Prospective Studies ; Skin ; Ultrasonography ; Valsalva Maneuver* ; Veins

Acrodermatitis enteropathica(AE) which starts in early infancy after weaning is a rare hereditary chronic disorder of zinc absorption. AE is characterized by alopecia, diarrhea and skin lesions localized to periorificial areas and acrally on the extremities. However, recent reports presented Transient Symptomatic Zinc Deficiency(TSZD) in preterm infants. TSZD is clinically similar to AE and skin lesions rapidly heals after zinc supplementation. When the treatment was withheld, no recurrence was seen. We experienced a TSZD case in a cow's milk fed, preterm infant, so We report it with a brief review of literature.
Absorption ; Acrodermatitis ; Alopecia ; Diarrhea ; Extremities ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature* ; Milk* ; Recurrence ; Skin ; Weaning ; Zinc*

Trypsin and DNase digestion technique has become a retinal digestion technique for studying diabetic retinopathy. We tried osmotic digestion method with DNase and compared the quality of preparation of retina and microvascular change with trypsin digestion in normal and diabetic rats. Streptozotocin-induced diabetic rats were sacrificed at 9, 18, 27weeks in 6 rats. Right retinas were digested with 3% trypsin while left wer digested with 0.1% DNase. For control, 18 normal rats were sacrificed at the same time. DNase was superior to trypsin for retinal preparation on the stainability, the degree of separating nonvascular fissue from vascular net, the degree of preservation of vascular net in normal & diabetic rats. In diabetic rats, the number of pericyte decreased significantly with age, which not in normal rats(p=0.0023) We suggest DNase digestion technique as an new alternative for trypsin digestion technique in the study of microvascular change of diabetic retinopathy.
Animals ; Deoxyribonucleases* ; Diabetes Mellitus ; Diabetic Retinopathy ; Digestion* ; Endothelial Cells ; Microvessels* ; Pericytes ; Rats* ; Retina ; Retinaldehyde* ; Trypsin*

Congenital lipoid adrenal hyperplasia, the most severe form of congenital adrenal hyperplasia, is caused by mutations in the steroidogenic acute regulatory protien (StAR). It is characterized by failure of synthesis of all three classes of adrenal steroids and massive accumulation of lipids and cholesterol in the adrenal cortex. The computed tomography (CT) unequivocally delineated massively enlarged adrenal glands of fat-tissue attenuation, enabling early diagnosis and replacement therapy. We report a case of congenital lipoid adrenal hyperplasia, in which CT established that lipoid deposition at the adrenal cortex disappeared after the adrenal hormone replacement therapy.
Adrenal Cortex ; Adrenal Glands ; Adrenal Hyperplasia, Congenital ; Cholesterol ; Early Diagnosis* ; Hormone Replacement Therapy ; Hyperplasia* ; Steroids

We compared the diagnostic accuracy of the simple x-ray with that of the computed tomography, and analyzed the surgical results according to the timing of operation in 52 patients with suspected orbital blowout fractures who complained diplopia after midfacial trauma. Of all the cases, 40 orbital fractures were confirmed with CT and forced duction test and the remaining 12 patients were thought to have transient functional impairment because the clinical signs were resolved with time. CT detected all the 40 actual fractures, so the dignostic accuracy(100%) was higher than that of the simple x-ray(75%) which detected 30 fractures of the 40 actual fractures(p=0.001). We operated 19 patients who have persistent diplopia, enophthalmos of more than 2 mm, and large fracture defect, and there was significant improvement of symptoms and signs in patients on whom operations were performed within 2 weeks after trauma rather than after 2 weeks.
Diagnosis* ; Diplopia ; Enophthalmos ; Humans ; Orbit* ; Orbital Fractures

To evaluate the efficacy of the intracanalicular silicone plug in dry eye, we performed lower horizontal canalicular occlusion with the Herrick lacrimal plug Twenty-eight of the 34 eyes(81 %) were able to discontinue or reduce to occasional use of the instillation of artificial tears and the remaining unsatisfactory 6 eyes were investigated by radiologic study for silicone plug. In 2 eyes, the plugs were invisible in radiologic study and the canaliculi were occluded repeatedly. In one of the four eyes with their plugs in place, upper canaliculus was occluded additionally. By thorough evaluation of the status of the plug by radiologic study and secondary attempt. 31 of the 34 eyes(91%) were able to discontinue or reduce to occasional use of the instillation of artificial tears. The intracanalicular plug has no protruded portion out of the puntum, so complications such as reflex tearing, conjunctival irritation, and loss of plug through the punctum, were not occurred. Waters' view with soft tissue density was effective in demonstration of silicone intracanalicular plug.
Dry Eye Syndromes* ; Ophthalmic Solutions ; Reflex ; Silicones* ; Tears